Organization
CITY DRUG STORE
Active
Other names
CITY DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ROBERT LOTT PHARMACIST (OWNER RPH)
(912) 265-7630
Entity
Organization
Contact information
Practice address
1402 NEWCASTLE ST, BRUNSWICK, GA 31520-7018
(912) 265-7630
(912) 262-1123
Mailing address
1402 NEWCASTLE ST, BRUNSWICK, GA 31520-7018
(912) 265-7630
(912) 262-1123
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
005563
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00192585A
—
GA
Enumeration date
07/30/2006
Last updated
01/31/2012
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